Obstetric labor pain recorder



June 20, 1961 w. A. VERRETT ETAL 2,989,357

OBSTETRIC LABOR PAIN RECORDER INVENTORS W004. E1129 4/ mm 1 [eh/W FiledApril 13, 1956 Wi W I ATTORNEYS United States Patent 2,989,357 OBSTETRICLABOR PAIN RECORDER Wallace A. Verrett, New Castle, Del. (3144 15th St.,Port Arthur, Tex. and Hazel V. Hebert, Brownsville, Tex. (2720 Ave. M,Nederland, Tex.)

'Filed Apr. 13, 1956, Ser. No. 578,066 2 Claims. (Cl. 346-72) Thisinvention relates to obstetrical apparatus, and in particular to adevice for recording the frequency of labor pains and their duration.

The timing of labor pains, as is well known, is of great importance inindicating the imminence of delivery and is relied upon to a greatextent in determining when the expectant person should leave home forthe hospital, and how long the doctor may safely delay in arriving atthe labor room. Through accurate determination of the timing of laborpains the expectant mother is frequently saved the expense of apremature trip to the hospital, based upon unreliable conjecture. Thetiming of these pains is also important in the labor room, for variousreasons.

In the hospital the standard rule seems to be that the expectant mothertells the nurse when a pain occurs and the nurse makes a written note ofthe time of recurrent pains. In this way the progressive shortening ofthe period between pains is ascertained and the doctor, if not present,is given timely notice of the approaching delivery.

Due to the multiplicity of duties incumbent upon the nurse, she is notalways at hand when the pain recurs and the pattern of frequency of thepains is interrupted and its significance to an extent nullified.

An experienced nurse can detect the periodic contraction of the uterusby applying the hand to the abdomen, but this method requires thecontinuous presence of the nurse at the labor bedside. It has beenproposed to substitute the nurse by a mechanical recorder to be placedupon the abdomen of the patient, operative responsive to sensing meanswhich detect the reflex contractions referred to. The use of suchapparatus requires that the patient remain supine, in bed, which is aninconvenience to most patients in cases of long labor when they wouldrather be sitting up or otherwise active, and the necessity of remainingprone while supporting such device, hampers the patient in resorting tothe normal straining that promotes delivery.

The principal object of the present invention is to provide a labor painrecorder, the operation of which does not necessitate that the patientbe lying down or in any other particular position, and which is notdesigned to respond to reflexive stimuli. On the other hand it is theprovision of a recorder which permits the patient to move about, sit upin any desired or comfortable position, and which is operated by thevoluntary act of the patient.

Another object of the invention is to provide a labor pain recorderhaving the virtue of extreme simplicity of construction and mode ofoperation so that there is no problem in instructing the expectantperson how to use it.

Other objects of the invention will appear as the following descriptionof a practical embodiment thereof proceeds.

In the drawing which accompanies and forms a part of the followingspecification, and throughout the several figures of which the samecharacters of reference have been employed to denote identical parts:

FIGURE 1 is a perspective view of the encased unit forming the apparatusof the invention, the case or cabinet being closed;

FIGURE 2 is a perspective view of the cabinet open and in part brokenaway to show the enclosed recorder, and the top being not shown;

FIGURE 3 is a fragmentary view partly in vertical elevation and partlyin section showing the pneumatically operated lifting mechanism formoving the pen of the recorder.

Referring now in detail to the several figures, the numeral 1 designatesas a whole a box-like cabinet having top, bottom, side and back wallsrespectively designated as 2, 3, 4, and 5, and a hinged front wall 6provided with a window 7. The front wall 6 may be let down to giveaccess to the recorder; when closed the chart of the recorder is visiblethrough the window. FIGURE 1 shows that the top of the casing isprovided with supporting bars 8, having downwardly turned ends 9, saidbars being pivoted at 10, and having two operative positions. In thefull line position they serve as latches for the front wall 6, and inthe broken line positions they function as means for supporting the uniton the framework of a bed. The downwardly inclined ends 9 terminate inupwardly hooked portions 11, which cooperate with loops 12 mounted onthe front wall for latching the cabinet in closed position. The top wallis provided with the bandle 13, by means of which the unit may becarried. A bulb 14 with flexible hose 15 is shown extending from therear of the cabinet. The hose is detachable from the recorder which iswithin the cabinet and may be neatly coiled and stowed within thecabinet when the apparatus is not in use or being transported.

FIGURE 2 illustrates the recorder which comprises a pair of rolls 16 and17 mounted on vertical parallel pins 19 and 20 near opposite ends of thecabinet, the pins being in a vertical plane parallel to the front wall 6of the cabinet when the latter is closed. The pin 19 is a shaft suitablyconnected to the roll 16, and having a beveled gear 20 which meshes witha similar gear 21, forming part of the clockwork 22 which is windable bymeans of a key 23. A chart sheet 24 is wound upon the roll 17, and hasan end attached to the roll 16, so that it is slowly wound off from theroll 17 upon the roll 16 by means of the clockwork. The roll 17surrounds the pin 20 with suflicient friction to keep the intermediateportion of the chart sheet taut and in a vertical plane. The chart sheetis marked with three horizontal lines, the lower line being the normwhich indicates no pain, and the upper horizontal lines indicatingrespectively medium and severe pains. The chart sheet is provided with apattern of equally spaced vertical lines indicating time intervals. Forexample, as shown, the distance which the sheet travels between twovertical lines represents five minutes.

A pen 25 is mounted in the middle of the cabinet at the top of avertical stem 26, which is vertically recipro cable, being guidedthrough eyes 27 and 28 extending in vertical alignment from a guide 29fixed to a supporting block 30 secured to the bottom wall 3 of thecabinet. The lower end of the stem 26 normally rests upon the block 30,and when in this position, the point of the pen 25 is on the horizontalnorm of the chart sheet. A pressure tube 31 is carried by the block 30,having a normally curved portion 32, the end of which is attached to thestem 26. When fluid pressure is admitted to the tube, it tends tostraighten out, the free end which is attached to the stem rising andlifting with the stem with the pen. The extreme lifting range carriesthe pen vertically until the point is on the horizontal line whichrepresents severe pain. The tube 15 and bulb 14 are attached to thelower end 33 of the pressure tube which extends laterally from a side ofthe block 30. The pen above the point is formed with a well 34 whichfrom time to time is supplied with ink by means of a medicine dropper.It is in present contemplation that one winding of the clockwork willoperate the recorder for twelve hours, although this feature isaltogether optional and not limiting as far as the invention isconcerned.

The recorder as described, is designed to be employed as part of thestandard hospital equipment, or to be carried as portable equipment byregistered or practical nurses or by doctors. When the expectant motherat home feels that the time for going to the hospital is approaching,and calls the doctor, he brings the labor pain recorderto the house,winds the clockwork, puts a drop or two of ink in the pen well, closesthe cabinet, and places it in any convenient spot such as upon thebureau, and instructs the patient to squeeze the bulb when a pain hitsyou, and release the bulb when the pain leaves." There is a naturaltendency for the expectant person to clamp her fists when a pain comes,and when the pain leaves a conscious relaxation is natural, so there isa good reason to believe that the instructions will be carried out. Thepatient need not go to bed, but may' remain sitting up, walking about ormaintaining herself as relaxed and comfortable as is possible under thecircumstances. The graph drawn by the pen is readily visible through thewindow in the front wall, the pains being represented by peaks in thegraph and when these reach the degree of frequency to which the patienthas been alerted by the doctor she may make immediate preparations toleave for the hospital.

In the use of the device in the hospital, it may be placed in thepatients room or supported upon the labor bed by means of the bars 8,and the chart may be read from time to time by the nurse on the spot orwho comes into the room frequently for the purpose of reading it. Thus,the recorder becomes a means by which the doctor may be given amplenotice to enable him to reach the hospital in time for the delivery.

The virtue of this apparatus over mechanical devices for recordinguterine contractions through the wall of the abdomen is the fact thatthe operation of the subject apparatus is entirely voluntary on the partof the patient, permits her the freedom to assume any position that shedesires, and which is comfortable for her, and enagage in any relaxedpursuit, while with the abdomen supported recorder the patient must liein one position during the entire labor period and hampered in herinstinctive efiorts to accelerate the approach of delivery. The sub jectinvention due to its simplicity of construction and mode of voluntaryself-operation, is much more accept able to the expectant mother as wellas to physicians and hospitals than involuntary recorders which requirethat the patient be restricted to one position during the labor period.

It will be understood by those skilled in the art that the specificdetails of construction and arrangement of parts, as shown anddescribed, are by way of illustration and not to be construed asnecessarily limiting the scope of the invention.

What we claim is:

1. Apparatus for voluntarily recording successive contractions of theuterus during the labor period permitting bodily freedom of the oneaifected, comprising in combination, a box-like cabinet having a hingedfront wall and a window in said wall, a carrying handle for said cabinetand means for supporting it upon a bed frame, a recorder mounted in saidcabinet having a chart sheet windable from one to the other of a pair ofspaced rolls on axes in a plane parallel to the plane of said windowwhen said front wall is closed, a clockwork connected to one of saidrolls, a pen contiguous to said chart sheet for marking a graphthereupon, and means movable responsive to fluid pressure operativelyconnected to said pen for moving it perpendicular to the direction ofmovement of said chart sheet, for making peaks in said graph, and aflexible hose connected to said movable member terminating in a bulbactuable at will by hand pressure of the one affected.

2. Apparatus for voluntarily recording successive contractions of theuterus during the labor period permitting bodily freedom of the oneaffected, comprising in combination, a recorder of the type including amoving chart sheet and a pen contiguous thereto for making a graph onsaid sheet, and means movable responsive to fluid pressure operativelyconnected to said pen for moving it perpendicular to the direction ofmovement of said chart sheet for making peaks in said graph, and aflexible hose connected to said movable means terminating in a bulbactuable by hand pressure at will of the one affected.

References Cited in the file of this patent UNITED STATES PATENTS349,780 Bernsee Sept. 28, 1886 414,963 Andersson Nov. 12, 1889 1,181,511Eder et a1. May 2, 1916 2,208,633 Heidbrink July 23, 1940 2,239,330Lorand Apr. 22, 1941 2,447,018 Keinath Aug. 17, 1948 2,556,645 CameronJune 12, 1951 2,708,367 Lusk May 17, 1955

